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Emanuel and mayors of 232 other U.S. cities sent Environmental Protection Agency head Scott Pruitt a letter outlining the negative public health effects they say would result from eliminating the plan, which is intended to reduce greenhouse gas emissions from the power sector 32 percent below 2005 levels by 2030.

“As the Trump administration fails yet again to provide certainty and support for local government and business by keeping the Clean Power Plan intact, I am proud to stand together with leaders from across the country to take decisive action to improve our environment while bettering our communities,” Emanuel said in a statement.

According to U.S. Climate Mayors, the group that organized the letter, meeting emissions reductions goals outlined in the plan could result in 57,000 fewer deaths per year due to poor air quality; 12,000 fewer deaths per year from extreme heat and cold; and up to $6.4 billion in savings from costs associated with severe rain.

The coalition of mayors behind the letter represents more than 51 million residents in 46 states and territories. They join a group of state leaders – including Illinois Attorney General Lisa Madigan – who last year condemned President Donald Trump’s executive order to roll back the Clean Power Plan.

Despite local efforts to reduce emissions and widespread criticism of the plan’s repeal, city leaders acknowledge that they are reliant on the federal government to achieve climate goals.

“The legal authority of cities and other municipalities generally extends only as far as their state governments and federal law allow,” the mayors wrote in the letter, “and as a result, our local efforts to address climate change are highly sensitive to national policies like the Clean Power Plan, which shape markets, steer state action, and have large direct impacts on nationwide emissions.”

Nov. 14: Since the inauguration of President Donald Trump, dozens of employees have left the EPA’s Region 5 office in Chicago. Current and former employees say the loss of staff is already putting a strain on operations.